Gaps between teeth, clinically known as a diastema, are common. This spacing is most frequently observed between the two upper front teeth. For many individuals, a tooth gap is purely cosmetic and poses no functional risk. However, in certain cases, a gap can signal an underlying oral health issue or contribute to future dental problems. Understanding the cause is the first step toward determining if professional attention is required.
Understanding Diastema and Common Causes
Diastema refers to a space measuring more than 0.5 millimeters between two adjacent teeth. While these spaces can appear anywhere, they are most noticeable in the upper dental arch. Causes often involve a mismatch between the size of the teeth and the jawbone; if teeth are small relative to the bone structure, excess space results, which is often genetic.
Another cause is an oversized labial frenum, the band of tissue connecting the upper lip to the gum line. If this tissue extends too low, it prevents the central incisors from moving together. Childhood habits, such as prolonged thumb-sucking or tongue-thrusting when swallowing, can also push the front teeth apart over time.
When Gaps Require Medical Attention
While many diastemas are harmless, they become a medical concern when they are caused by or contribute to functional problems. A significant indicator that a gap is problematic is when it arises from advanced periodontal disease (gum disease). The infection damages the underlying bone and supporting structures, causing teeth to loosen and shift, which creates or widens spaces.
If the gap results from bone loss, gum disease treatment must be completed first to stabilize the teeth. Gaps can also lead to issues with bite alignment, known as malocclusion, especially if spacing causes neighboring teeth to drift. Furthermore, a pronounced gap between the front teeth may affect speech articulation, sometimes contributing to a lisp or whistling sound.
Professional Options for Closing Gaps
If a diastema needs to be closed for medical reasons or aesthetic concerns, several professional treatment options are available.
Orthodontics
For gaps resulting from size or positioning issues, orthodontics is a reliable solution. This utilizes traditional braces or clear aligners to move the teeth together. This method is effective for larger gaps and simultaneously corrects any related alignment or bite irregularities.
Cosmetic Bonding and Veneers
A less invasive option for smaller gaps is cosmetic bonding. A tooth-colored composite resin is applied to the edges of the teeth and sculpted to fill the space. This procedure is often completed in a single appointment and is less expensive than other restorative options.
Porcelain veneers offer another approach, involving custom-made, thin shells bonded to the front surface of the teeth. Veneers create a wider appearance to close the space. They provide a more durable and long-lasting result than bonding but require a small amount of enamel removal from the natural tooth.
Frenectomy
When an oversized labial frenum is the root cause, a minor surgical procedure called a frenectomy may be performed to remove the excess tissue. Following this procedure, orthodontic treatment is often still required to fully close the remaining gap, especially in adults.